P0177 Impact of genetic polymorphisms of MTHFR, SLC, and ABC on high-dose methotrexate toxicity and plasma levels in adults with haematological malignancies

2014 ◽  
Vol 50 ◽  
pp. e60 ◽  
Author(s):  
S. Suthandiram ◽  
G.-G. Gan ◽  
S. Mohd Zain ◽  
P.-C. Bee ◽  
L.-H. Lian ◽  
...  
Keyword(s):  
Genetic Polymorphisms ◽  
Plasma Levels ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Haematological Malignancies ◽  
Dose Methotrexate ◽  
Methotrexate Toxicity

Plasma levels of 7-hydroxymethotrexate after high-dose methotrexate treatment

1983 ◽  
Vol 11 (1) ◽  
Author(s):  
G. Milano ◽  
A. Thyss ◽  
N. Renee ◽  
M. Schneider ◽  
M. Namer ◽  
...  
Keyword(s):  
Plasma Levels ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
Methotrexate Treatment

Re-challenge with High Dose Methotrexate vs. Reduced Dose After Methotrexate Toxicity in Pediatric Osteosarcoma:Case Report

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Walid Ibrahim ◽  
Alam Alhuda Mohamed ◽  
Nawaf Alkhayat ◽  
Yasser Elborai
Keyword(s):  
Renal Impairment ◽  
Supportive Care ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Reduced Dose ◽  
Dose Methotrexate ◽  
Methotrexate Toxicity ◽  
Renal Complications ◽  
Leucovorin Rescue ◽  
Pediatric Osteosarcoma

Introduction: Methotrexate (MTX), a classic antifolate, is one of the most widely used and well-studied anticancer agents. High-dose methotrexate (HD-MTX) with folinic acid (leucovorin) rescue is one of the standard therapies for osteosarcoma. High-dose methotrexate (HDMTX) can exert significant toxicity and requires complex pharmacokinetic monitoring and leucovorin rescue. The side effect profile of MTX varies markedly according to the dose. Regimens containing MTX are classified as high, intermediate, or low-dose. High-dose methotrexate (HD-MTX; 12 g/m2) is a part of the golden standard therapy for pediatric osteosarcoma (OS). Risk factors associated with MTX toxicity in children with OS are not well defined. Case Presentation: We report here a case of pediatric osteosarcoma with nephrotoxicity associated with delayed MTX excretion who was successfully managed using supportive measures that encouraged us to re-challenge with a full dose of MTX then we reduced the dose to 50% to attain the final critical decision about continuation or changing the regimen of treatment for the patient. Our patient developed moderate renal complications during therapy that improved with supportive care, so we challenged with more cycles of a high dose MTX, but the patient developed serious renal complications. A reduced dose of MTX with 50% was given successfully without any renal impairment. Conclusion: Methotrexate toxicity that might not occur during the initial courses of high-dose MTX is not a predictive of the tolerability of further courses and re-challenging with HDMTX is risky, but reduced dose methotrexate is a good option rather than changing the regimen, with good tolerability and rapid clearance of HDMTX. HDMTX-induced renal impairment occurs in a low percentage of patients with osteosarcoma and can be managed successfully by maximum supportive care. MTX clearance can be affected by gender and age.

Modulation of high-dose methotrexate toxicity by a non-toxic level of 5-fluorouracil

Toxicology ◽  
1986 ◽  
Vol 41 (1) ◽  
pp. 61-73 ◽  
Author(s):  
Terry J. Robbins ◽  
Donnell Bowen ◽  
Quang Q. Bui ◽  
Minh-Tam Tran
Keyword(s):  
High Dose ◽  
High Dose Methotrexate ◽  
Toxic Level ◽  
Dose Methotrexate ◽  
Methotrexate Toxicity
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